Cognition
What is Cognition?
Cognition refers to our processes and functions related to thinking, memory, and processing information. Cognition plays an important role in everyone's daily lives. It enables us to interact with the world and people around us by helping us make decisions, learn, adapt to new situations and problem solve.
MS is a condition that affects the central nervous system (CNS), including the brain, and as a result if the MS damage occurs in the area that controls cognition you may find changes in these functions. These cognitive changes can be mild or made worse by fatigue. For some people, they can be a lot more challenging than physical problems.
Cognitive problems
Information processing – MS can mean your brain's ability to understand information is slowed down. This may make you feel overloaded and you may need more time to answer questions, make decisions or make sense of information. It is the most common cognitive change.
Memory Problems – Some people find they forget what they are saying or don't remember events, appointments, names, and directions. This can also have an effect on learning new information.
Attention and concentration – MS can impact a person's ability to focus and concentrate for long periods, to multitask, or switch attention from one task to another.
Visual processing – Some people with MS have difficulties with spatial awareness (knowing where they are in relation to their surroundings). Examples of this are, finding their way in unfamiliar environments, or driving somewhere new.
Language and communication – MS may cause word-finding difficulties where expressing thoughts clearly can be a challenge.
Learning – Sometimes learning new skills can be difficult and repeated exposure to the new information is necessary and takes more time to learn.
Executive function – These functions include planning, organising, doing things in the right order, time management, and the ability to problem-solve. People may have difficulty making, or achieving goals.
What does the MS Service do to help with cognitive changes?
If you find that you are experiencing cognitive changes, or have any concerns about your cognition, you should discuss this with your MS practitioner at your review, or you can contact the MS helpline.
If it is felt your MS may have caused cognitive changes, you will be referred to one of our MS specialist OTs for a cognitive assessment.
Practical tips for managing cognitive problems:
- Limit distractions - turn off radio, TV, phone.
- Actively focus and raise attention levels.
- Focus on one task at a time and complete this before moving onto the next.
- Allow more time to process (both written and spoken) information.
- Plan your most challenging cognitive tasks for when you are at your best.
- Establish a routine.
- Use organisational techniques - to do lists, daily planner, filing system, written plans and schedules.
- Ask anyone who is giving information to keep it simple and to write down any key points.
- Arrange important discussions at a time when you are not fatigued or arrange to have a rest beforehand.
- When reading a lot of material, for example at work, try alternating short bursts of reading with another activity.
- Allow extra time to practice when learning something new, this can improve your ability to recall information later.
- Use errorless learning. This means having systems in place, e.g. a written process, so you don't make mistakes, whilst you are learning something new.
Other factors that influence cognition
Fatigue - MS related fatigue can lead to temporary cognitive changes. It is important to use fatigue management strategies. See fatigue
Medication - Some MS medications can affect cognition. Discuss with your MS practitioner if you are concerned.
Fluid intake – Even mild dehydration has been shown to reduce memory and other cognitive performance. It is important to ensure that you are drinking plenty of water every day.
Exercise - Regular exercise can have cognitive benefits. People who have active lifestyles may experience less cognitive impairment. Regular exercise also improves mood but should be balanced to avoid fatigue. See exercise and activity
Infections – Infections such as urinary tract infections (UTIs) or other illnesses can worsen cognitive difficulties.
Sleep - Poor sleep can be very harmful to cognitive function. It is worth seeing the section on sleep if you are struggling regularly to sleep well. See sleep
